Introduction:
Competition in the generic-heavy type 2 diabetes market is intensifying as brands struggle to
attain and hold market share. In this edition of
Strategic Assessment of
Managed Markets, Decision Resources examines the relationship between a drug’s
formulary placement and level of access in each of the 50 largest US cities and ties this directly to the drug’s performance. In each city we examine the
five largest managed care organizations’ formulary tier structure and
prescribing limitations placed upon antidiabetic agents. In addition we are
introducing a truly unique and insightful examination of the prevalence of type
2 diabetes and the projected drug treatment rates for each of the 50 major
markets to identify areas of under-treatment and possible growth opportunities.
In this report
we examine the dynamic type 2 diabetes market managed care strategy within the United States among branded products. Recent safety concerns with PPAR-gamma agonist formulations
have made an early impact in market share among the top brands in the type 2
diabetes market. Actos and Avandia, two products in the middle of their life
cycle, have held the top two brand positions within this market for some time, but
increasing competition from new DPP-IV introductions Januvia and Janumet
threatens to challenge their market dominance. The DPP-IV introductions are
gaining attention as the next breakthrough in diabetes treatment and are making
progress building market share within the top 50 MSAs, especially considering
that they currently have very limited formulary access within these markets.
Fixed-dose combinations constitute the middle of the type 2 diabetes market yet
may see their overall share decline in the wake of PPAR-gamma agonist safety
concerns and the introduction of new agents into the marketplace. Byetta, an
injectable GLP-1 analogue, exhibits strong growth and the improved delivery
profile of newer formulations will also influence Byetta’s market share.
For easy
review we provide both an in-depth report that highlights the findings of our
research and three Excel-based dashboards organized for each city (MSA), health
plan, and branded drug. Each dashboard examines the dominant drivers of
performance such as formulary tier status, restrictions to access, co-pay for
generic, preferred brand and non-preferred brand. In addition, we examine the
plans spend level by generics and brand (preferred and non-preferred) and, in
the MSA dash, we provide disease prevalence numbers, drug-treated estimates,
dominant managed care organizations ranked by commercially insured Rx lives,
and the formulary status for major brands prescribed to control diabetes.
This combined
insight provides a unique examination of the type 2 diabetes drug market viewed
through the filters of formulary access and MSA prevalence to drug
treated ratio to provide actionable avenues to increase market share of
marketed drugs or to plan the launch of a novel agent into the type 2 diabetes
market.